| Page (PDF) | 13 |
|---|---|
| Certificate Number | 995 |
| Name of Deceased | Collic, Samuel |
| Place of Death | Worcester |
| Town of Death | near Snow Hill |
| Sex | M |
| Race | colored |
| Married, Widowed, or Single | single |
| Date of Birth | 11/1/1913 |
| Age (year, month, days) | 4 mos |
| Occupation or Employer | none |
| Birthplace | near Snow Hill Md |
| Father's Name | Samuel Waters |
| Father's Birthplace | Worcester |
| Mother's Name | Wollie Hormman |
| Mother's Birthplace | near Snow Hill Md |
| Informant (Relationship and Address) | Elzie Hommon; Snow Hill Md |
| Date of Death | 1/6/1914 |
| Cause of Death and Time Attended by Doctor | marasuius; 2 mos |
| Immediate, Secondary, or Contributory Cause and How Long | – |
| Physician and Address | John L Riley; Snow Hill |
| Burial Place, Date, Undertaker, and Address | Coston lot Cemetery; 1/7/1914; WM S Williams; Snow Hill |
| Length of Residence, Where Disease Contracted, Former Residence | – |
| Other Notes | – |
If you are citing this record, please use the following format:
[Author (if known)], Maryland Death Certificates (Somerset, Wicomico, Worcester Counties), 1910-1922, [Date (if known)], Enduring Connections: Exploring Delmarva’s Black History, Nabb Research Center, Salisbury University.
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